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Zhou Q, Tang Y, Yuan L, Xu L, Yu L, Yu Z, Zhang Q. Establishment of a nomogram for predicting functional constipation among children in China: Using the Rome IV criteria. Arab J Gastroenterol 2023; 24:204-210. [PMID: 37532661 DOI: 10.1016/j.ajg.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND AND STUDY AIMS Childhood functional constipation (FC) is gradually becoming an emerging public health problem. This study aimed to develop a personalized nomogram for the prediction of incident FC among Chinese children, and the diagnosis of FC was based on the Rome IV criteria. PATIENTS AND METHODS This cross-sectional study was conducted from Nov. 2020 to Jan. 2021 among children residing in Anhui province, China. An electronic questionnaire regarding the general demographic and clinical characteristics of all children was completed by their primary caregivers. The multivariate logistic regression analysis was applied to identify risk factors for FC. Moreover, a nomogram was constructed for FC based on the risk factors identified from the multivariate analysis. RESULTS In this study, a total of 901 electronic questionnaires were collected, of which 832 (92.3%) questionnaires were properly completed and included in the final analysis. The prevalence of FC among Chinese children was 11.3% based on the Rome IV criteria. After controlling for potential confounding factors, the multivariate logistic regression analysis showed that inadequate sleep, picky eating, and positive family history of FC were identified as key risk factors of FC. The area under the receiver operating characteristic curve of the nomogram was 0.694 (95 %CI: 0.6412-0.7459). Further, a calibration curve drawn illustrated that the predicted probabilities reasonably approximately the actual prevalence of FC in this population. CONCLUSION Inadequate sleep, picky eating, and positive family history of FC were identified as risk factors of FC. An easy-to-use nomogram was constructed based on these three significant factors. Besides, this nomogram was validated to have acceptable discrimination and calibration capabilities. Hence, this nomogram may enable clinical professionals to predict the risk of FC among Chinese children and further provide optimized disease prevention and intervention for this population.
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Affiliation(s)
- Qilian Zhou
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Yuxia Tang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Liping Yuan
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Lingling Xu
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Lijuan Yu
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Zhuchun Yu
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
| | - Qianqian Zhang
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
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Liyanarachchi H, Rajindrajith S, Kuruppu C, Chathurangana P, Ranawaka R, Devanarayana NM, Benninga MA. Association between childhood constipation and exposure to stressful life events: a systematic review. Neurogastroenterol Motil 2022; 34:e14231. [PMID: 34415089 DOI: 10.1111/nmo.14231] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 06/23/2021] [Accepted: 07/13/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Several cross-sectional studies have reported an association between childhood constipation and exposure to stressful events. We planned to systematically review the literature on constipation and its associated stressful events. METHODS PubMed, Embase, and PsycINFO databases were searched (until February 2021) using standard search terms related to "constipation" and "stress" from 0 to 18 years that describe the association between psychological stressors and constipation. Studies were screened using pre-designed eligibility criteria. Studies that fulfilled the criteria were reviewed in a full-text format. The quality assessment of selected articles was conducted using standard methods. KEY RESULTS Of 2296 titles and abstracts screened, 38 were included in the full-text review. Out of that, 15 articles were included in this systematic review. There were 2954 children with constipation, and the age range was from 6 months to 16 years. Exposure to home-related stressors (divorce or separation of parents, severe illness in family, and parental job loss) school-related stressors (including being bullied at school, change in school, separation from the best friend at school, and failure in an examination), exposure to child maltreatments and exposure to war/civil unrest were associated with childhood constipation. CONCLUSIONS AND INFERENCES Exposure to day-to-day home- and school-related stressors, to child maltreatment, and to civil unrest is associated with constipation in children and adolescents. These factors need to be explored during clinical evaluation of children with constipation.
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Affiliation(s)
- Hasitha Liyanarachchi
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Shaman Rajindrajith
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | | | - Prasad Chathurangana
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Randula Ranawaka
- Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.,Lady Ridgeway Hospital for Children, Colombo, Sri Lanka
| | - Niranga M Devanarayana
- Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children Hospital, Amsterdam University Medical Center, Amsterdam, The Netherlands
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Dos Santos IR, de Abreu GE, Dourado ER, Martinelli Braga AAN, Lobo VA, de Carvalho IWB, Bastos Netto JM, Barroso U. Emotional and behavioural problems in children and adolescents: The role of constipation. J Paediatr Child Health 2021; 57:1003-1008. [PMID: 33565678 DOI: 10.1111/jpc.15368] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 11/29/2022]
Abstract
AIM The functional constipation (FC) is a source of an expressive suffering in children, negatively affecting their emotional, social, and physical well-being. The objective of this study is to describe the clinical and behavioural characteristics of children/adolescents with FC. METHODS A cross-sectional, observational, analytical study was conducted in public places by interviewing parents of children/adolescents about their child's bowel habits and psychological profile. Bowel symptoms were investigated using the Rome IV criteria. The Strengths and Difficulties Questionnaire (SDQ) was used to evaluate the emotional and behavioural problems. RESULTS Of 799 children/adolescents included, 424 (53.1%) were female. Mean age was 9.1 ± 2.7 years. FC prevalence was 20.4%. The most common symptoms in Rome IV criteria were 'painful or hard bowel movements' (n = 110; 67.5%; 95% confidence interval: 60.0-74.3) and 'retentive posturing or excessive volitional stool retention' (n = 89; 54.6%; 95% confidence interval: 46.9-62.1). Median scores for internalising symptoms (7; interquartile range (IQR): 4-9 vs. 5; IQR: 2-7; P < 0.001) and externalising symptoms (7; IQR 4-11 vs. 6; IQR 3-9; P < 0.001) were higher in constipated children compared to non-constipated participants, respectively. The SDQ domains that were associated with FC were emotional symptoms (median 4, P < 0.001) and conduct problems (median 3, P < 0.001). No association was found between faecal incontinence and median scores for the internalising/externalising symptoms. All Rome IV criteria were associated with abnormal overall SDQ scores. CONCLUSION Children and adolescents with FC had more emotional and behavioural problems irrespective of whether faecal incontinence was present or not, with higher scores for internalising and externalising symptoms compared to non-constipated children.
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Affiliation(s)
- Ivana R Dos Santos
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Glícia E de Abreu
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Eneida R Dourado
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Ana A N Martinelli Braga
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | - Victoria A Lobo
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil
| | | | - José M Bastos Netto
- Division of Urology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Ubirajara Barroso
- Center for Children's Urinary Disorders (CEDIMI), Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.,Urology Department, Hospital das Clínicas, Federal University of Bahia, Salvador, Bahia, Brazil
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Erdur B, Ayar M. The treatment of functional constipation significantly increased quality of life in children aged 4-17 years. TURKISH JOURNAL OF GASTROENTEROLOGY 2020; 31:814-818. [PMID: 33361045 DOI: 10.5152/tjg.2020.19509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND/AIMS In this study, it was aimed to investigate the effect of 6-week treatment on quality of life in 4-17-year-old children with functional constipation. MATERIALS AND METHODS The children 4-17 years old diagnosed as functional constipation according to Rome IV criteria, between June and December 2018 were included in the study. KINDL scales were applied to patients and their parents before starting treatment for 6 weeks and after the end of the treatment. RESULTS The study was completed with 42 patients. The majority of the patients (54,8%) were female cases and the general part of them (45,2%) were between 4-6 years old. The age at onset of constipation was found to be 5,19±3,658 years. Total KINDL scores of both children and parents were lower before the treatment. Significant improvement was observed in the symptoms of constipation after 6 weeks of treatment. There was a statistically significant (p<0,05) increase in children's subgroup and total KINDL scores after treatment. Parental subgroup and total KINDL scores also showed a statistically significant (p<0,05) increase after treatment. The treatment of functional constipation was found to be highly effective with the eyes of both children and parents in improving the quality of life. (Eta value, η2. >0,25) Conclusion: A significant increase was observed in all areas of life quality and total score in children with functional constipation after a regular treatment. We think that the treatment of children with functional constipation will significantly improve their quality of life.
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Affiliation(s)
- Barış Erdur
- Department of Pediatric Gastroenterology, Dr Behcet Uz Child Disease and Surgery Training and Research Hospital, İzmir, Turkey
| | - Murat Ayar
- Department of Pediatrics, Dr Behcet Uz Child Disease and Surgery Training and Research Hospital, İzmir, Turkey
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Yıldırım A, Biçer Ş, Hacıhasanoğlu-Aşılar R, Özdamar MY, Şahin H, Gül V. The Effect of Education Given to Children with Functional Constipation and Fecal Incontinence and Their Mothers on Anxiety and Constipation Management. Florence Nightingale Hemsire Derg 2020; 28:321-332. [PMID: 34263211 PMCID: PMC8134022 DOI: 10.5152/fnjn.2020.19134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/17/2020] [Indexed: 11/30/2022] Open
Abstract
AIM This study aimed to determine the effect of multidimensional training program on children with constipation and fecal incontinence and their mothers on anxiety and their constipation management. METHOD The study had an experimental design with a pretest-posttest control group. The intervention group consisted of children diagnosed with functional constipation (n=20) and fecal incontinence (n=21) and their mothers in the Pediatric Surgery Clinic. The control group consisted of healthy (n=20) children who applied to two different Family Health Centers for any reason. Data were collected between February 2016 and June 2017 using a descriptive questionnaire, a nutrient consumption frequency form, the Rome III diagnostic criteria form, and the Trait Anxiety Scale for Children. RESULTS After the training program, the mean score of the Trait Anxiety Scale for Children decreased in both intervention groups (p<0.01) and increased in the control group (p<0.05). In addition, the frequency of the consumption of milk, caffeinated drinks, and white bread was reduced in the children of both intervention groups after the training program. The consumption of dried legumes, vegetables, and whole wheat bread increased. According to the Rome III diagnostic criteria, it was determined that constipation symptoms were not observed in 50% of the children. CONCLUSION The training program had a significant influence on the prevention and management of constipation and anxiety. Given that constipation is associated with both physical and mental health outcomes, the approach for the treatment should be holistic in nature, involving a multidisciplinary team.
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Affiliation(s)
- Arzu Yıldırım
- Department of Psychiatric Nursing, Yalova University Faculty of Health Sciences, Yalova, Turkey
| | - Şenol Biçer
- Department of Pediatric Surgery, Erzincan Binali Yildirim University School of Medicine, General Surgery, Erzincan, Turkey
| | | | - Mustafa Yaşar Özdamar
- Department of Pediatric Surgery, Erzincan Binali Yildirim University School of Medicine, General Surgery, Erzincan, Turkey
| | - Hilal Şahin
- Division of Dietetics, Department of Nutrition and Dietetics, Erzincan Binali Yildirim University Faculty of Health Sciences, Erzincan, Turkey
| | - Vahdet Gül
- Division of Medical Biochemistry / Internal Medicine, Department of Mental Health and Diseases, Erzincan Binali Yildirim University School of Medicine, Basic Medical Sciences, Erzincan, Turkey
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Flankegård G, Mörelius E, Duchen K, Rytterström P. Experiences of parents who give pharmacological treatment to children with functional constipation at home. J Adv Nurs 2020; 76:3519-3527. [PMID: 33043491 PMCID: PMC7702076 DOI: 10.1111/jan.14539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/22/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022]
Abstract
Aim The aim was to explore the lived experiences of parents who give oral and rectal pharmacological treatment to their children with functional constipation at home. Design A phenomenological design with a reflective lifeworld research approach that describes phenomena as they are experienced by individuals. Methods From January–May 2019, 15 interviews were conducted with parents of children with functional constipation with home‐based oral and rectal treatment. Parents were recruited from three different healthcare levels. Open‐ended questions were used starting from the description of a normal day with constipation treatment. Analyses were made with an open and reflective ‘bridling’ attitude. Findings Constipation treatment causes parents to question their parental identity and what it means to be a good parent. Forced treatment makes them feel abusive and acting against their will as parents. There is a conflict between doubt and second thoughts about the treatment, the urge to treat based on the child's needs and encouragement from healthcare professionals to give treatment. Conclusion As pharmacological constipation treatment can be experienced as challenging, it is important to help parents make an informed decision about how such treatment should be carried out at home. The findings reveal a medical treatment situation where parents hesitate and children resist, resulting in insecure parents who question their parental identity. Impact The findings point to the importance of supporting parents in treatment situations. Healthcare providers need to treat children with constipation with greater focus and more prompt management to prevent these families from lingering longer than necessary in the healthcare system.
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Affiliation(s)
- Gunilla Flankegård
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Faculty of Health Sciences, Linköping University, Norrkoping, Sweden
| | - Evalotte Mörelius
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Faculty of Health Sciences, Linköping University, Norrkoping, Sweden.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia
| | - Karel Duchen
- Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Patrik Rytterström
- Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences, Faculty of Health Sciences, Linköping University, Norrkoping, Sweden
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Williams KC, Rogers LK, Hill I, Barnard J, Di Lorenzo C. PEG 3350 Administration Is Not Associated with Sustained Elevation of Glycol Levels. J Pediatr 2018; 195:148-153.e1. [PMID: 29395181 DOI: 10.1016/j.jpeds.2017.11.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 10/19/2017] [Accepted: 11/15/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To determine whether trace amounts of ethylene glycol (EG), diethylene glycol (DEG), or triethylene glycol (TEG) in PEG 3350 are associated with increased blood levels of EG, DEG, or TEG in children receiving daily PEG 3350 therapy. STUDY DESIGN Blood samples were drawn from 9 children who were being treated for constipation with PEG 3350 (6-12 years old) before and every 30 minutes for 3 hours after receiving 17 g of PEG 3350. PEG 3350, tap water, and blood samples from 18 age- and sex-matched controls also were analyzed. RESULTS Baseline blood levels of EG and TEG did not differ between control and treated groups. DEG levels (median [IQR]) were lower in the PEG 3350 group (40.13 ng/mL [36.69, 63.94] vs 92.83 ng/mL [51.06, 128.93], P = .008). After PEG 3350 dose, levels of EG (390.51 ng/mL [326.06, 624.55]) and TEG (2.21 ng/mL [0, 4.5]) peaked at 90 minutes at 1032.81 ng/mL (826.84, 1486.13) (P = .009) and 35.17 ng/mL (15.81, 45.13) (P = .0005), respectively. DEG levels did not significantly change. Standard 17-g doses of PEG 3350 in 8 oz (237 mL) of water resulted in concentrations (mean ± SD) of EG, DEG, and TEG of 1.32 ± 0.23 µg/mL, 0.18 ± 0.03 µg/mL, and 0.12 ± 0.01 µg/mL, respectively. EG, DEG, and TEG levels in public water supply were 0.07 µg/mL, 0.21 µg/mL, and 0.02 µg/mL, respectively. CONCLUSIONS Daily PEG 3350 therapy in children was not associated with sustained elevation of EG, DEG, or TEG blood levels over levels in matched controls. Although EG and TEG levels increased after a standard dose of PEG 3350, their peak values remained well below toxic levels.
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Affiliation(s)
- Kent C Williams
- Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, Ohio State University, Columbus, OH.
| | - Lynette K Rogers
- Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, Ohio State University, Columbus, OH
| | - Ivor Hill
- Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, Ohio State University, Columbus, OH
| | - John Barnard
- Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH; Research Institute at Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, Ohio State University, Columbus, OH
| | - Carlo Di Lorenzo
- Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH; Department of Pediatrics, Ohio State University, Columbus, OH
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Coronel ALC, Silva HTH. [Domestic violence and constipation: an integrative review]. REVISTA PANAMERICANA DE SALUD PUBLICA = PAN AMERICAN JOURNAL OF PUBLIC HEALTH 2017; 41:e19. [PMID: 31391817 PMCID: PMC6660885 DOI: 10.26633/rpsp.2017.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 08/25/2016] [Indexed: 11/24/2022]
Abstract
Objetivo. Buscar evidências na literatura sobre a relação entre violência doméstica e constipação intestinal. Metodologia. Foi realizada uma revisão integrativa, baseada no método preconizado em seis etapas e construída conforme a metodologia PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Foram examinados artigos publicados entre 2005 e 2015 que relacionassem violência doméstica e constipação intestinal. As buscas ocorreram em setembro e outubro de 2015 nas bases de dados PubMed, MEDLINE, Scopus e Web of Science. A seleção compreendeu três etapas: busca, pré-seleção e inclusão de artigos. Resultados. Dos 177 artigos inicialmente identificados, foram selecionados 11. Dos 11 selecionados, sete eram quantitativos, três eram qualitativos e um era misto. Quatro enfocaram crianças e adolescentes, dois investigaram o conhecimento médico sobre a relação entre violência doméstica e constipação intestinal, um revisou distúrbios digestivos em idosos, um avaliou os resultados do biofeedback em constipados com e sem histórico de violência, um avaliou disfunção evacuatória e relacionou o resultado de defecografias com histórico de violência doméstica e dois estudos eram relatos de especialistas. Três estudos apresentaram nível de evidência 1B e grau de recomendação A. Todos os estudos detectaram relação entre violência doméstica e constipação intestinal. Conclusão. Os resultados desta revisão indicam que existe correlação entre violência doméstica e constipação intestinal. É recomendável a investigação dessa relação nas práticas em saúde.
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Affiliation(s)
- Ana Lúcia Couto Coronel
- Universidade Federal de Ciências da Saúde de Porto Alegre Programa de Pós-Graduação em Ensino na Saúde Porto Alegre (RS) Brasil Universidade Federal de Ciências da Saúde de Porto Alegre, Programa de Pós-Graduação em Ensino na Saúde, Porto Alegre (RS), Brasil
| | - Helena Terezinha Hubert Silva
- Universidade Federal de Ciências da Saúde de Porto Alegre Departamento de Patologia e Medicina Legal e Programa de Pós-Graduação em Ensino na Saúde Porto Alegre (RS) Brasil Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Patologia e Medicina Legal e Programa de Pós-Graduação em Ensino na Saúde, Porto Alegre (RS), Brasil
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Rezazadeh A, Javaherizadeh H, Chahardahcherik F, Yavarahmadi MH, Sadjadei N, Tahmasebi M. RELIABILITY OF BARR, LEECH, AND BLETHYN SCORE IN USING OF PLAIN RADIOGRAPHY IN DETERMINING FECAL IMPACTION IN CHILDREN WITH AND WITHOUT CONSTIPATION. ARQUIVOS DE GASTROENTEROLOGIA 2016; 53:141-5. [PMID: 27438417 DOI: 10.1590/s0004-28032016000300004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 03/04/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND - Several scoring was developed for evaluation of children with fecal retention using plain radiograph. There are controversies about specificity and sensitivity of these scoring system. OBJECTIVES - The aim of this study was to evaluate Barr, Blethyn, and Leech score in evaluation of fecal load in plain radiograph. METHODS - This case control study was conducted on children aged 2-14 years old with abdominal pain who visited Abuzar children's Hospital of Ahvaz University of Medical Sciences. This study was conducted in fall season. Children with history of previous abdominal surgery, any systemic illness including sickle cell anemia were excluded. Children with constipation were placed in case group. Subjects without constipation were placed in control group. Subjects without exclusion criteria were examined by physician who is blind to aim of the study. Careful history and physical examination was done. Demographic features, history of gastrointestinal problem, duration of abdominal pain, defecation habit, stool consistency (loose, hard), and results of physical examination were recorded. Rome III criteria was used for definition of constipation. Abdominal x-ray was ordered for each patients. Abdominal radiography was reviewed by radiologist. Barr, Leach, and Blethyn scores were calculated for each case. RESULTS - In this study 102 children with functional constipation and 102 children without constipation as a control were included. Mean ±SD for case and control group was 68.39±34.88 and 69.46±32.60 (P=0.82).Leech score (mean ±SD) was 11.05±2.177 and 5.67±3.228 for case and control group respectively (P<0.0001). Barr score (mean ±SD) was 14.86±3.54 and 7.16±5.59 for case and control group respectively (P=<0.0001). Blethyn (mean ±SD) score was 1.97±0.667 and 1.04±0.900 for case and control group respectively (P=0.000). Sensitivity and specificity of Barr score was 83% and 79% respectively. Sensitivity and specificity of Leech score was 92% and 80% respectively. Sensitivity and specificity of Blethyn score was 79% and 92% respectively. CONCLUSION - Barr, Blethyn and Leech scores were significantly higher in children with abdominal pain and constipation in contrast to children with abdominal pain and without constipation. Sensitivity of Leech score was more than Barr and Blethyn scoring systems. Specificity of Blethyn score was more than Barr and Leech score.
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Affiliation(s)
- Afshin Rezazadeh
- Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hazhir Javaherizadeh
- Nursing Care Research Center in Chronic Diseases and Dept. of Pediatric Gastroenterology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Nooshin Sadjadei
- Nursing Care Research Center in Chronic Diseases and Dept. of Pediatric Gastroenterology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Morteza Tahmasebi
- Department of Radiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Akça ÖF, Aysev A, Aycan İÖ. Familial Features and Comorbid Psychiatric Disorders in Children with Encopresis. ACTA ACUST UNITED AC 2016. [DOI: 10.5455/bcp.20110502050441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Ayla Aysev
- University of Ankara School of Medicine Child Psychiatry Clinic, Ankara-Turkey
| | - İrem Öker Aycan
- University of Ankara School of Medicine Child Psychiatry Clinic, Ankara-Turkey
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11
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Alpaslan AH, Koçak U, Avci K, Güzel HI. Association between elimination disorders and abusive maternal attitudes. J Forensic Leg Med 2016; 40:22-7. [DOI: 10.1016/j.jflm.2016.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/28/2016] [Accepted: 02/20/2016] [Indexed: 11/17/2022]
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12
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van Dijk M, de Vries GJ, Last BF, Benninga MA, Grootenhuis MA. Parental child-rearing attitudes are associated with functional constipation in childhood. Arch Dis Child 2015; 100:329-33. [PMID: 25359759 DOI: 10.1136/archdischild-2014-305941] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Parenting factors are assumed to play a role in the development and maintenance of childhood constipation. However, knowledge about the association between parenting factors and childhood constipation is limited. This study investigates the association between parental child-rearing attitudes and prominent symptoms of functional constipation and assesses the strength of this association. DESIGN Cross-sectional data of 133 constipated children and their parents were collected. SETTING The gastrointestinal outpatient clinic at the Emma Children's Hospital in the Netherlands. PATIENTS Children with functional constipation aged 4-18 years referred by general practitioners, school doctors and paediatricians. MAIN OUTCOME MEASURES Parental child-rearing attitudes were assessed by the Amsterdam version of the Parental Attitude Research Instrument (A-PARI). Symptoms of constipation in the child were assessed by a standardised interview. Negative binomial and logistic regression models were used to test the association between child-rearing attitudes and constipation symptoms. RESULTS Parental child-rearing attitudes are associated with defecation and faecal incontinence frequency. Higher and lower scores on the autonomy attitude scale were associated with decreased defecation frequency and increased faecal incontinence. High scores on the overprotection and self-pity attitude scales were associated with increased faecal incontinence. More and stronger associations were found for children aged ≥6 years than for younger children. CONCLUSIONS Parental child-rearing attitudes are associated with functional constipation in children. Any parenting issues should be addressed during treatment of children with constipation. Referral to mental health services is needed when parenting difficulties hinder treatment or when the parent-child relationship is at risk. TRIAL REGISTRATION NUMBER ISRCTN2518556.
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Affiliation(s)
- Marieke van Dijk
- Psychosocial Department, Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Giel-Jan de Vries
- Psychosocial Department, Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Department of Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Bob F Last
- Psychosocial Department, Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Department of Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Marc A Benninga
- Department of Paediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Kilincaslan H, Abali O, Demirkaya SK, Bilici M. Clinical, psychological and maternal characteristics in early functional constipation. Pediatr Int 2014; 56:588-93. [PMID: 24373103 DOI: 10.1111/ped.12282] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 11/04/2013] [Accepted: 12/17/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND This cross-sectional study investigated the clinical features of functional constipation (FC) at preschool age, as well as emotional and behavioral characteristics of the children, psychological symptom level and parental attitudes of the mothers, and compared these with that of non-referred typically developing controls with normal intestinal habits. METHODS Participants included 65 children with FC (mean age, 43.6 ± 15.4 months; range, 25-72 months), 59 healthy controls (mean age, 46.9 ± 14.5 months; range, 25-72 months) and the mothers of the children. The Childhood Behavior Checklist, Symptom Checklist 90 and Parental Attitude Research Instrument were filled in by the mothers. RESULTS Participants with FC had higher problem scores than the comparison children in a variety of emotional and behavioral parameters. Approximately half exhibited internalizing and one-third had externalizing problems in the clinical range. The mothers of the patient group had higher levels of psychological distress, overprotective parenting and strict discipline. On multiple logistic regression analysis child psychopathology, maternal education level and maternal distress were independently associated with FC. CONCLUSION Behavior problems are common in children with FC from an early age. Low level of education and high psychological distress of the mothers seem to be important risk factors for constipation and should be assessed carefully in the management of these cases.
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Affiliation(s)
- Huseyin Kilincaslan
- Department of Pediatric Surgery, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Devanarayana NM, Rajindrajith S. Association between constipation and stressful life events in a cohort of Sri Lankan children and adolescents. J Trop Pediatr 2010; 56:144-8. [PMID: 19696192 DOI: 10.1093/tropej/fmp077] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Emotional stress is associated with some functional gastrointestinal diseases, but its role in aetiology of functional constipation is unclear. This island-wide, questionnaire-based, cross-sectional survey was conducted to assess the association between constipation and emotional stress, in 10-16-year-olds. Constipation was defined using Rome III criteria. Out of 2699 children included in the analysis, 416 (15.4%) had constipation. Constipation was higher in those exposed to stressful events (odds ratio 2.52, p < 0.0001). Separation from the best friend, failure in an examination, severe illness of a family member, loss of job by a parent, frequent punishment by parents and living in an area affected by separatist war remained independently associated with constipation (p < 0.05). In conclusion, constipation was significantly higher in children exposed to stressful life events. Modulation of gut motility through brain-gut axis probably alters colonic transit and ano-rectal functions, causing constipation.
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